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Individual

DR. MARK BIDWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3533 SOUTHERN BLVD, SUITE 4100, KETTERING, OH 45429-1264
(937) 395-8444
(937) 395-8450
Mailing address
1 PRESTIGE PL, SUITE 550, MIAMISBURG, OH 45342-3794
(937) 752-2305
(937) 522-7513

Taxonomy

Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
35052666
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0599946
OH
01
38587
NO.CAROLINA LICENSE NO.
OH
01
884330E
AMERICAN BD. OF OBGYN
Enumeration date
10/03/2006
Last updated
07/28/2014
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